Patient may complain of burning sensation of the mouth and throat immediately after ingestion. Nausea, vomiting, belching, abdominal pain and diarrhea or constipation are symptoms suggestive of gastrointestinal tract involvement. [1,4]

Fever

In kerosene poisoning fever is a common symptom. Fever may persists for few days. Fever may be the presenting feature if the patient has developed pneumonitis after few days of kerosene ingestion. [1,2]

Smell of kerosene

Often parents or caretakers of adults complain of smell of kerosene around the patient. [2]

Accidental poisoning

Children and elderly patients are at risk of accidental ingestion. [1]

People who are at risk of deliberate selfharm

People who have depression, anxiety, impulsivity and low self-esteem are at risk of suicide. Drug misuse, family members with attempts of deliberate selfharm also play a significant role. [3]

Management - General Measures

Fact

Explanation

Health education

Substances should be stored in a safe and closed place, out of reach of children. In a case of ingestion, clothes, if contaminated should be removed. Skin and hair should be washed thoroughly with soap and water. If poisoning is suspected patient should be transported to the nearest hospital immediately with the suspected hydrocarbon container in order to correctly identify the poison and to guide the treatment. [1]

Basic life support

Patients airway, breathing and circulation should be assessed and managed accordingly. Patency of the airway should be established and oxygen should be given if necessary. [1]

Antiemetics

Patients with vomiting should be treated with antiemetics, because emesis either spontaneous or induced is considered harmful, especially in kerosene poisoning. [1,2]

Antipyretics

Effective in controling fever. [1]

Anticonvulsants

Patients with seizures should be given anticonvulsants. [1]

Gastric lavage

Gastric lavage is not routinely indicated in hydrocarbon poisoning because of the significant risk of aspiration and chemical pneumonitis. It is rarely practiced when the risk of systemic toxicity is more than the risk of aspiration. [3]

Management - Specific Treatments

Fact

Explanation

Initial patient resuscitation

Initial focus should be to assess and to optimize patient's airway, breathing and circulation. Airway should be kept patent in patients with impaired consciousness or coma. Oxygen should be administered in all hospital admitted patients via a face mask while monitoring the oxygen saturation. Patients with severe respiratory distress and hypoxia need early intubation and mechanical ventilation with positive end-expiratory pressure or with continuous positive airway pressure. In patients with vomiting a nasogastric tube will minimize the risk of aspiration. [1,2]

Management of arrhythmia

Patients can develop cardiac arrhythmias secondary to hydrocarbon ingestion. Antiarrhythmic drugs or electrical defibrillation may be needed depending on the type of arrhythmia. ECG monitoring is necessary through out the treatment process. [3]

Antibiotic prophylaxis against aspiration pneumonia

This is not routinely indicated. In the presence of symptoms and signs of acute infection antibiotic prophylaxis is indicated. [2,5]